TOPICAL DMSO TREATMENT OF MACULAR AND PAP ULAR AMYLOIDOSIS

Macular amyloidosis (MA) and lichen amyloidosus (LA) a re the two majo r variants of the primary cutaneous amyloidoses which present with sev ere and therapy resistent itching. Various therapeutic modalities such as antihistamines, intralesional injection or topical application of corticosteroids, etretinate, UVB irradiation and dermo-abrasion have b een employed with variable success. Recently, in a few case reports au thors have observed encouraging beneficial clinical effects by using t opical dimethyl sulphoxide (DMSO). In our study 10 patients with eithe r MA or IA or biphasic amyloidosis were treated with a 50% solution of DMSO in water. 9 of them showed marked clinical improvement at the en d of 6-20 weeks of treatment. Degranulation and depletion of the mast cells by DMSO is the most probable explanation for the rapid improveme nt of itching beginning within the first week of therapy. Remarkable f lattening of the lichenoid papules which was obtained within 11 weeks of treatment is interpreted as a result of the improvement of itching and the related scratch effect. Histological examination after treatme nt revealed no disappearance of amyloid deposits in the papillary derm is. In the follow-up period relapses of itching and papules were obser ved. Therefore further studies are needed to find out the optimal proc edure of therapy.